Journal of Urgent Care Medicine

The Placebo Effect and Its Clinical Implications in Urgent Care

Urgent Message: The placebo effect can produce clinical manifestations of various disease states, particularly for pain. It has practical clinical implications for urgent care clinicians who routinely recommend oral medications for pain. Vinay Sharma, BS; Ariana M. Nelson, MD Keywords: acute pain; chronic pain; placebo effect; expectation; verbal suggestion; endogenous opioid signaling; dopamine signaling; placebo analgesia; medical ethics Abstract The placebo effect—the nonspecific beneficial effect of a medical treatment—involves complex psychological, biological, and physiological interactions. …

Occult Presentation of Necrotizing Fasciitis With Subtle Clinical Findings: A Case Report

Urgent Message: Necrotizing fasciitis may present without visible soft tissue abnormalities. Therefore, clinical signs and symptoms—including localized pain and tachycardia—are findings that should warrant further clinical investigation. Abstract Introduction: Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection. Early NF may present to urgent care without visible soft tissue abnormalities. As such, clinical signs and symptoms, including localized pain with tachycardia, should warrant further clinical investigation. Case Presentation: A 43-year-old male presented to …

Recognizing and Managing Adrenal Crisis in Urgent Care: A Case Report

Urgent Message: Adrenal crisis is uncommon in the urgent care setting, but it can be rapidly fatal if diagnosis is missed. Early administration of hydrocortisone and fluid resuscitation with correction of electrolyte abnormalities are essential to reduce mortality. Clayton R. Halford, PA-C Keywords: adrenal crisis; adrenal insufficiency; Addison disease; hypoglycemia; hyperkalemia; pediatric endocrine emergency Abstract Introduction: Adrenal (Addisonian) crisis is a rare but life-threatening endocrine emergency that can present to urgent care with nonspecific symptoms. …

Behçet Disease: Atypical Presentation in a Non-Endemic Geographical Region

Urgent Message: Behçet disease may present atypically in non-endemic regions, and ocular involvement requires urgent specialty evaluation to prevent irreversible vision loss. James McClellan, BS; Kimberly M. Rathbun, MD, PhD, MPH Keywords: vision loss; retinal vasculitis; panuveitis; Behçet disease; branch retinal artery occlusion; branch retinal vein occlusion Abstract Introduction: Behçet disease is a multisystemic inflammatory disease affecting large, medium, and small blood vessels that has an unpredictable and recurrent pattern. Behçet disease has a wide …

Updated Evidence-Based Pediatric Asthma Management for the Urgent Care Provider

Urgent Message: Acute asthma exacerbations commonly present to urgent care, and providers must be well-equipped to recognize asthma exacerbations and be familiar with management recommendations. Samantha Shear, DO; Laura Calderon Suarez, MD; Maria Sara Valle Nodal, MD Keywords: pediatric asthma; asthma exacerbation; spirometry; inhaled corticosteroids; bronchodilator therapy; urgent care Abstract Overview: Asthma affects nearly 10% of children globally, with an estimated 95.7 million cases reported in 2021. This review discusses updates from the 2025 Global …

Brugada Syndrome in the Urgent Care Center: A Case Report

Urgent Message: Brugada syndrome may present with subtle electrocardiogram findings, and clinicians must recognize the pattern promptly to help prevent sudden cardiac death. Katherine Quinn, MS IV; Eric Mast, DO; M. Drew Mattin, MS IV; Todd Fredricks, DO, MSS Keywords: sudden cardiac death; Brugada syndrome; Brugada pattern; ventricular fibrillation Abstract Introduction: Syncope in young, otherwise healthy individuals is often attributed to benign causes but can occasionally signal life-threatening cardiac conditions. Brugada syndrome (BrS), a rare …

Pediatric Plantar Puncture Wound Through Rubber-Soled Footwear: A Case Report Highlighting Antibiotic Stewardship in Urgent Care

Urgent Message: Low-risk plantar puncture wounds in healthy children can be safely managed without antibiotics. Parents should receive instructions for return precautions. Adam Brandon Bondoc, MD Keywords: plantar puncture wound; pediatric puncture wound; rubber-soled footwear; pseudomonas aeruginosa; antibiotic stewardship; foreign body risk Abstract Introduction: Puncture wounds that occur through rubber-soled footwear increase the risk of infection from Pseudomonas aeruginosa. Prophylactic oral fluoroquinolones are frequently provided to adults for high-risk injuries. However, pediatric care is complicated …

An Evaluation of Unnecessary Prophylactic Antibiotics For Clean Lacerations

Urgent Message: Prophylactic antibiotic prescribing for patients with clean lacerations is a common but unnecessary practice. Rates of prescribing did not differ based on type of provider or physician specialty in this study of 20 urgent care centers. Michael Smart, PhD; Jennifer Bush, MSN, APRN, FNP-C/ENP-C Keywords: antimicrobial stewardship; prophylactic antibiotics; laceration repair; urgent care Abstract Background: Oral prophylactic antibiotics for clean lacerations that require suture repair are commonly prescribed when they are unneeded. We …

An Uncommon Cause of Rectal Pain: A Case Report of Fishbone Foreign Body

Urgent Message: Careful history and examination are required when assessing patients presenting with rectal pain. Clinicians should maintain a high index of suspicion for accidental foreign-body ingestion when assessing unexplained rectal discomfort. Ivan Koay, MBChB, MRCS, FCUCM, FRNZCUC, MD; Cameron Olphert, BSc (Hons), MSc Key Words: rectal pain; foreign body; proctoscopy; fishbone ingestion; hemorrhoids; gastrointestinal issues Abstract Clinical Presentation: A 50-year-old male with a history of type 2 diabetes mellitus and hemorrhoids presented to urgent …

Wheezing as a Pneumothorax Presentation: A Case Report

Urgent Message: For patients with presumed asthma exacerbation, clinicians must maintain a high index of suspicion for other etiologies, including pneumothorax. This may help avoid delays in potentially life-saving interventions when symptoms persist despite treatment or when physical exam findings are atypical. Badi Eghterafi, DO; Nazanin Hazhir Karzar, MD Keywords: asthma, wheezing, chest pain, pneumothorax, spontaneous pneumothorax Abstract Introduction: Large spontaneous pneumothorax is an uncommon but critical complication in patients with asthma. Clinicians evaluating presumed …

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